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What if the Cost Projections Are Wrong?

Editor’s note: There appear to be no fail safe mechanisms in the new bill, in the event that the cost projections turn out to be wrong and it costs more. Even if there are fail-safe triggers, will a future Congress have the will to allow them to be triggered? See physician reimbursement under SGR (Sustainable Growth Rate) over the past 12 years. Does the phrase, “Not on My Watch” come to mind?

This from the NY Times:

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But even some lawmakers who voted for the Senate bill have been calling in recent weeks for additional steps to be taken to guarantee that new spending will not spiral out of control. They also want to ensure that Congress will follow through on proposed cuts, especially reductions to slow the growth of Medicare.

Many experts have warned that members Congress may not have the stomach to carry out the proposed cuts in the future. In January, five Democratic senators, including Michael Bennet of Colorado and Mark Warner of Virginia, sent a letter to the Senate majority leader, Harry Reid of Nevada, urging him to include a “fail-safe” mechanism in the final bill that would result in cuts if spending were to exceed estimates.

Representative Chet Edwards, Democrat of Texas, noted the absence of such a fail-safe when he voted against the House bill in November.

“I am especially disappointed that the bill does not have a fiscal trigger in it to cut spending if actual costs of new programs turn out to be higher than projected,” Mr. Edwards said in a statement. “While the Congressional Budget Office predicts this bill is paid for over 10 years, there is no mechanism in the bill to force spending cuts if those complicated projections turn out to be wrong.”

So far, there is no indication from the White House or Democratic Congressional leaders that they would include such a mechanism in the legislation. One Senate leadership aide dismissed the idea as a “second tier” issue at a time when officials are focused on how they can make final changes to the core components of the health care legislation through the budget reconciliation process.

After the health care summit meeting last week, Mr. Altmire said the legislation still seemed “weak” on cost containment.

Representative Lincoln Davis, Democrat of Tennessee, who voted against the House bill in November, raised similar concerns after the summit meeting last week.

“America has the best health care system in the world, but we need to work on reducing its costs,” Mr. Davis said in a statement. “Folks in my district could care less about the partisan gamesmanship that is being waged by ideologues who are only interested in scoring political points, they want affordable and accessible care, and they want an honest discussion on workable solutions.”